Medical hypotheses最新文献

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Why do pacifiers/dummies have a protective effect in sudden infant death Syndrome? A new hypothesis 为什么奶嘴/奶嘴对婴儿猝死综合症有保护作用？一个新的假设

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-01 DOI: 10.1016/j.mehy.2024.111517

Paul N. Goldwater

The American Academy of Pediatrics recommends pacifier/dummy use to help prevent sudden infant death syndrome (SIDS). This recommendation is based on studies that have shown pacifier use reduces the risk of SIDS even under conditions regarded as increasing the risk of SIDS. Several unrelated mechanistic explanations have been used to explain this. These prior suggested mechanisms purported to underly the observed protective effect of pacifiers have not proven satisfactory and highlight the need for a more plausible explanation. Pacifier use is associated with increased salivary production. Saliva contains numerous antibacterial compounds that could provide a protective effect against bacterial colonisation. Infection is considered a key player in SIDS pathogenesis given that most SIDS risk factors relate to or align with infection, whereas mainstream research focusses on central homeostatic control of breathing, arousal and heart function. These, however, lack association with risk factors. Given infection is significant in the SIDS story, the increased production and antibacterial effect of saliva could provide an alternative mechanism worthy of consideration in the context of known preventable risk factors in the drive to reach a better understanding of SIDS pathogenesis and further decrease the incidence of SIDS.

美国儿科学会建议使用安抚奶嘴/奶嘴来帮助预防婴儿猝死综合症（SIDS）。这项建议的依据是，有研究表明，即使在被认为会增加婴儿猝死综合症风险的条件下，使用安抚奶嘴也能降低婴儿猝死综合症的风险。有几种不相关的机制被用来解释这种情况。这些先前提出的机制被认为是所观察到的安抚奶嘴保护作用的基础，但事实证明这些机制并不令人满意，因此需要更合理的解释。使用安抚奶嘴与唾液分泌增加有关。唾液中含有多种抗菌化合物，可对细菌定植起到保护作用。感染被认为是婴儿猝死综合症发病机制中的关键因素，因为婴儿猝死综合症的大多数风险因素都与感染有关或相一致，而主流研究则侧重于呼吸、唤醒和心脏功能的中枢稳态控制。然而，这些因素与风险因素缺乏关联。鉴于感染在婴儿猝死综合症中的重要性，唾液分泌的增加和抗菌作用可能提供了另一种值得考虑的机制，结合已知的可预防风险因素，从而更好地了解婴儿猝死综合症的发病机理，进一步降低婴儿猝死综合症的发病率。

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引用次数: 0

Stress and periodontal disease: Is the relationship bidirectional? If yes, is MMP- 8 one of the connecting links? 压力与牙周病：这种关系是双向的吗？如果是，那么 MMP- 8 是其中的一个连接环节吗？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-28 DOI: 10.1016/j.mehy.2024.111508

Shipra Gupta , Shubham Sareen , Ismo T. Räisänen , Timo Sorsa , Prabhleen Kaur Brar

There is sufficient evidence to indicate that a unidirectional link exists between chronic stress and periodontal disease, with stress leading to a greater degree of periodontal tissue destruction in patients susceptible to it. Modification in behaviour related to life style such as oral hygiene, smoking and diet in patients under stress eventually adds on to the risk for periodontal disease onset and progression. Recently, a link between the alteration in social behaviour, stress and increased levels of matrix metalloproteinase-8 (MMP-8) has been established. As periodontal diseases are also characterized with disruption of cytokine response, resulting increase in the levels of MMP-8 could hence be considered as directly or indirectly augmenting this relationship even further. Hence the relationship between stress and periodontal disease might be bidirectional with each worsening the other, with MMP-8 acting as one of the connecting links. Correlation nowhere suggests causation, however the proposed hypothesis could definitely be considered a matter of future research.

有足够的证据表明，慢性压力与牙周病之间存在着单向联系，压力会导致易受其影响的患者的牙周组织受到更大程度的破坏。压力过大的患者在口腔卫生、吸烟和饮食等生活方式方面的行为改变，最终会增加牙周病发病和恶化的风险。最近，人们发现社会行为的改变、压力和基质金属蛋白酶-8（MMP-8）水平的增加之间存在联系。由于牙周病也具有细胞因子反应紊乱的特点，因此 MMP-8 水平的增加可被视为直接或间接地进一步加剧了这种关系。因此，压力与牙周病之间的关系可能是双向的，两者都会加重对方的病情，而 MMP-8 则是其中的一个连接点。相关性并不能说明因果关系，但所提出的假设绝对可以被视为未来研究的一个事项。

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引用次数: 0

Targeting disease self-healing to designing new drugs and new treatment technologies for human diseases 以疾病自愈为目标，设计人类疾病的新药物和新治疗技术

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-28 DOI: 10.1016/j.mehy.2024.111509

Maosheng Yang

The treatment of human diseases has always been the top priority and tough issue in medical science. It is of great practical significance and clinical value to develop new drugs and new treatment technologies for human diseases. In order to explore a new path of research and development of new drugs and new treatment technologies for human diseases, the literature relating to disease self-healing from Google Scholar, PubMed database, and Websites is retrieved and analyzed. It is well known that many human diseases have the possibility of self-healing. According to the above findings, a novel hypothesis of developing new drugs and new treatment technologies for human diseases targeted on triggering disease self-healing and a technical road-map for further in-depth research are put forward. It is hoped that the hypothesis above can provide an important insight for the research and development of new drugs and new treatment technologies for human diseases in the future.

人类疾病的治疗一直是医学科学的重中之重和难点问题。研发治疗人类疾病的新药和新治疗技术具有重要的现实意义和临床价值。为了探索人类疾病新药和新治疗技术研发的新路径，我们从谷歌学术、PubMed 数据库和网站中检索并分析了与疾病自愈相关的文献。众所周知，许多人类疾病都有自愈的可能。根据上述研究结果，提出了以引发疾病自愈为目标开发人类疾病新药和新治疗技术的新假说，以及进一步深入研究的技术路线图。希望上述假说能为未来人类疾病新药和新治疗技术的研发提供重要启示。

引用次数: 0

Dynamic tissue distraction may enhance therapeutic efficacy for Critical limb ischemia 动态组织牵引可提高临界肢体缺血的疗效

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-21 DOI: 10.1016/j.mehy.2024.111507

Zhishan Du, Liqiong Li, Xing Zhang, Lingwei Deng, Fuguo Wang, Bo Zhu, Jiachen Li

Critical limb ischemia (CLI) is the most serious stage of lower limb arterial disease, often presenting as severe ischemic resting pain, ulcer or tissue gangrene. The treatments for CLI pose a medical challenge. Despite the various treatments available for CLI, there is still no treatment that is entirely effective and acceptable to all patients. Patients with CLI are often elderly and have complex medical conditions, multiple comorbidities, and limited surgical tolerance. Among CLIs, patients with Transatlantic Inter-Society Consensus (TASC) grade D typically exhibit long-segmental and diffuse vascular lesions in their lower extremity arteries, often accompanied by microvascular lesions. It is obviously difficult to reopen multiple extensive segmental vessels with open bypass surgery or endovascular treatment within the limited surgical time, and such methods are ineffective in improving microcirculation. As emerging techniques for lower limb microcirculation reconstruction, tibial cortex transverse distraction and periosteal distraction are both forms of distraction histogenesis (DH) technology, their efficacy in treating CLI is verified, yet their associated treatment parameters still have potential for optimization. Existing biomechanical researches suggest that dynamic stretching may yield superior biological outcomes compared to static stretching, we hypothesize that employing dynamic stretching in tissue distraction techniques may yield a better therapeutic effect, thereby enhancing the efficacy of DH techniques for CLI and reducing the associated complications.

重度肢体缺血（CLI）是下肢动脉疾病最严重的阶段，通常表现为严重的缺血性静息痛、溃疡或组织坏疽。重度下肢缺血的治疗是一项医学挑战。尽管针对慢性缺血性心肌梗死有多种治疗方法，但仍没有一种治疗方法是完全有效且所有患者都能接受的。CLI 患者通常年事已高，病情复杂，合并多种疾病，手术耐受力有限。在 CLI 患者中，跨大西洋学会间共识（TASC）D 级患者的下肢动脉通常表现为长段、弥漫性血管病变，并常伴有微血管病变。显然，在有限的手术时间内，很难通过开放式搭桥手术或血管内治疗重新开放多个广泛的节段性血管，而且这些方法对改善微循环效果不佳。作为下肢微循环重建的新兴技术，胫骨皮质横向牵张术和骨膜牵张术都是牵张组织生成（DH）技术的一种形式，其治疗CLI的疗效已得到验证，但其相关的治疗参数仍有优化的可能。现有的生物力学研究表明，与静态拉伸相比，动态拉伸可能会产生更好的生物学效果，因此我们假设在组织牵引技术中采用动态拉伸可能会产生更好的治疗效果，从而提高 DH 技术治疗慢性缺血性心肌梗死的疗效并减少相关并发症。

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引用次数: 0

Is brachiation a prelude to the evolution of the hominin throwing shoulder? 肱骨化是类人投掷肩进化的前奏吗？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-20 DOI: 10.1016/j.mehy.2024.111506

S. Akshatha

引用次数: 0

Hypothesizing the interplay of thrombus formation, wall enhancement, and perifocal edema as predictive factors for rupture in brain AVMs 推测血栓形成、壁强化和灶周水肿的相互作用是脑动静脉畸形破裂的预测因素

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-15 DOI: 10.1016/j.mehy.2024.111496

Riccardo Ludovichetti , Tze Phei Kee , Taryn Rohringer , Karel G. Terbrugge , Timo Krings

The presence of shear stress within intracranial AVMs (arteriovenous malformations) due to high flow, perinidal angiogenesis, intranidal aneurysms, and biological factors are presumed risk factors for rupture. However, emerging imaging and histological evidence suggests that risk factors for AVM rupture may extend beyond the classical understanding. The presence of perifocal edema at the time of rupture, luminal thrombosis, and vessel wall enhancement on vessel wall MRI elucidate the possibility of an underlying inflammatory process within AVMs, which may predispose them to instability and eventual rupture. We hypothesize that for some AVM ruptures, the occurrence of thrombosis within vascular outpouchings of the AVM initiates a cascade of events, including local hypoxia, inflammation, breakdown of the blood–brain barrier and wall matrix degradation, which is evident from the presence of perifocal edema and vessel wall enhancement observed on imaging. These changes might ultimately raise the risk of AVM rupture and subsequent hemorrhage. Understanding this inflammatory component offers promising insights into AVM pathogenesis and may facilitate the development of preventive strategies to mitigate rupture risk.

颅内动静脉畸形（动静脉畸形）内由于高流量、潮周血管生成、潮内动脉瘤和生物因素而产生的剪切应力被认为是导致破裂的危险因素。然而，新出现的成像和组织学证据表明，动静脉畸形破裂的风险因素可能超出了传统的理解。破裂时出现的灶周水肿、管腔血栓形成以及血管壁核磁共振成像显示的血管壁强化，都阐明了动静脉畸形内部可能存在潜在的炎症过程，这可能会导致动静脉畸形不稳定并最终破裂。我们推测，在某些 AVM 破裂的情况下，AVM 血管外袋内血栓的形成会引发一系列事件，包括局部缺氧、炎症、血脑屏障破坏和血管壁基质降解。这些变化最终可能会增加 AVM 破裂和随后出血的风险。了解这种炎症成分有助于深入了解动静脉畸形的发病机制，并有助于制定预防策略以降低破裂风险。

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引用次数: 0

Exploring the feasibility of pharmacologic management in non-traumatic osteonecrosis: An etiology-based hypothesis 探索非创伤性骨坏死药物治疗的可行性：基于病因学的假设

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-09 DOI: 10.1016/j.mehy.2024.111497

Edward Y. Cheng, Alireza Mirzaei

Non-traumatic osteonecrosis is a debilitating condition with a major health burden for the patients. Nevertheless, effective pharmacologic interventions for non-traumatic osteonecrosis are lacking. Increasing evidence suggests a complex interplay between a lipid metabolic disorder and chronic inflammation in the development of osteonecrosis. However, there is no consensus on which of these aberrations initially occurs in the pathogenic sequence of non-traumatic osteonecrosis, as both can mutually and synergistically induce the initiation of each other, perpetuating a recurring process spiraling into the disease state. Furthermore, other pathogenic mechanisms, such as coagulopathy and endothelial dysfunction, have been introduced for non-traumatic osteonecrosis. Understanding the root pathogenic cause of non-traumatic osteonecrosis is important, as therapeutic options should focus on the root cause of the disorder to provide the highest therapeutic impact. Identifying the root pathogenic cause, when feasible, provides a basis for developing pharmacologic strategies tailored to the etiology of osteonecrosis. If the pathogenic sequence originates from a lipid metabolic disorder, pharmacologic interventions should prioritize optimizing lipid metabolism. Conversely, if the primary pathogenic cause is chronic inflammation, anti-inflammatory medications better serve patients. Depending on the underlying mechanisms, additional medications like anti-coagulants could also be considered. In this article, we first provide some clues to determine the root pathogenic cause of non-traumatic osteonecrosis and then suggest an etiology-based pharmacologic intervention based on the potential root pathogenesis.

非创伤性骨坏死是一种使人衰弱的疾病，对患者的健康造成很大负担。然而，目前尚缺乏针对非创伤性骨坏死的有效药物干预。越来越多的证据表明，骨坏死的发生与脂质代谢紊乱和慢性炎症之间存在复杂的相互作用。然而，在非创伤性骨坏死的致病过程中，哪种畸变最先发生尚无共识，因为这两种畸变可相互协同诱发另一种畸变，使疾病状态螺旋式上升。此外，非创伤性骨坏死还引入了其他致病机制，如凝血功能障碍和内皮功能障碍。了解非创伤性骨坏死的根本致病原因非常重要，因为治疗方案应着眼于疾病的根本原因，以提供最高的治疗效果。在可行的情况下，确定根本致病原因可为制定针对骨坏死病因的药物治疗策略提供依据。如果致病序列源于脂质代谢紊乱，那么药物干预应优先考虑优化脂质代谢。相反，如果主要的致病原因是慢性炎症，那么抗炎药物会更好地为患者服务。根据潜在的机制，还可以考虑使用抗凝剂等其他药物。在本文中，我们首先为确定非创伤性骨坏死的根本病因提供了一些线索，然后根据潜在的根本病因提出了基于病因的药物干预建议。

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引用次数: 0

Leptin, acne and JAK-inhibitors: A possible correlation? 瘦素、痤疮和 JAK 抑制剂：可能的相关性？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-10-09 DOI: 10.1016/j.mehy.2024.111498

Luca Potestio , Maddalena Napolitano , Cataldo Patruno

引用次数: 0

How might acne and prostate cancer be connected? 痤疮和前列腺癌有什么联系？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-09-27 DOI: 10.1016/j.mehy.2024.111495

Mark R. Goldstein , Luca Mascitelli

Acne and prostate cancer are in part indirectly connected by dietary characteristics that lead to overstimulation of cellular growth signaling. Further, they are directly connected by a proinflammatory phylotype of the acne related bacterium, Cutibacterium acnes, which spreads from acne affected skin to prostate tissue and exists there chronically within a biofilm it secretes, resulting in a local inflammatory and immunosuppressive microenvironment, eventually culminating in prostate cancer initiation and progression. The diet-acne-prostate cancer nexus needs to be explored further and has implications regarding diet, antibiotics, and vaccinations in the prevention and treatment of prostate cancer.

痤疮和前列腺癌在一定程度上因饮食特点而间接相关，饮食特点会导致细胞生长信号的过度刺激。此外，与痤疮相关的痤疮丙酸杆菌的一种促炎系统型也将它们直接联系在一起，这种细菌会从痤疮患者的皮肤扩散到前列腺组织，并长期存在于其分泌的生物膜中，从而形成局部炎症和免疫抑制微环境，最终导致前列腺癌的发生和发展。饮食-痤疮-前列腺癌之间的关系有待进一步探讨，它对饮食、抗生素和疫苗在预防和治疗前列腺癌方面的作用也有影响。

引用次数: 0

Abulia is mediated by the neural pathways responsible for passivity symptoms with initiated actions remaining subject to conscious veto 阿布利娅由负责被动症状的神经通路介导，启动的行动仍然受到意识的否决

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-09-25 DOI: 10.1016/j.mehy.2024.111494

Lana Frankle

引用次数: 0

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